Improving Survival in Acquired Immunodeficiency Syndrome: Is Experience Everything?.

The perception of acquired immunodeficiency syndrome (AIDS) as a medical disease is changing. Previously considered fatal in the short term and amenable only to palliative measures, AIDS now is viewed increasingly as a long-term disease, human immunodeficiency virus (HIV) infection, in which therapy might significantly prolong life and some complications might be totally preventable. This changing perception has important implications for how health care services to people with HIV infection might be provided in the future, and it likely will influence the ongoing debate over the advisability of creating dedicated AIDS centers.

In the early years of the epidemic, patients with AIDS often were treated aggressively in research hospitals. However, appreciation of the high fatality associated with the disease despite such efforts soon resulted in an emphasis on compassionate, low-technology care aimed at improving the quality rather than the length of life. Intensive support measures such as intubation were believed